[68Ga]‑DOTA‑conjugated somatostatin receptor‑targeting peptide PET for the differentiation between meningioma and glioblastoma: A case report and review of the literature.

Abstract

[⁶⁸Ga]-tetraazacyclododecanetetraacetic acid (DOTA)-conjugated positron emission tomography (PET) is widely used to identify meningiomas due to their high expression of somatostatin receptor type 2 (SSTR2). However, recent evidence suggests that this tracer may also show uptake in high-grade gliomas, raising concerns about its diagnostic specificity. The current study presents a challenging case of a 56-year-old man who was initially diagnosed with a right temporal glioblastoma. Follow-up imaging revealed a local recurrence and a new extra-axial lesion suggestive of meningioma on magnetic resonance imaging and [⁶⁸Ga]-DOTA-octreotide (DOTATOC) PET. Unexpectedly, histopathological analysis following resection confirmed both lesions as glioblastomas, indicating that SSTR2 uptake is not exclusive to meningiomas. A systematic literature review further supports the fact that high-grade gliomas can exhibit [⁶⁸Ga]-DOTA tracer uptake, though generally at lower levels than meningiomas. These findings suggest that while [⁶⁸Ga]-DOTA PET provides useful diagnostic information, interpreting results requires caution in cases where glioblastoma might mimic meningioma. Future research should focus on establishing clear thresholds to reliably distinguish between meningiomas and high-grade gliomas, enhancing diagnostic precision and treatment planning in neuro-oncology.